Provider Contract and Pricing Analyst

• Provides analysis and documentation that supports pricing requirements, contract design and contract configuration to accurately apply reimbursement allowances.
• Provides pricing analyzed for claims in accordance to the contract reimbursement language.
• Interpreting medical/insurance codes such for procedure and diagnosis.
• Support testing and audit requirements.
• Update customer specific documentation and reference materials.
• Participates in client meetings representing our team for full understanding of client intent.
• Participates and facilitates meetings to support decision making, enhancements, problem solving and process improvement.
• Answers inquiries from clients, claims and customer service.
• Documents policy and procedures.
• Contributes towards daily departmental performance and service level guarantees and achieves individual performance goals around accuracy and timeliness.

• Strong understanding of pricing methodologies for insurance claims.
• 3-5 years of experience in insurance industry.
• Strong CPT/HCPCS Procedure code, revenue code and ICD 10 knowledge.
• High aptitude for working with numbers.

• Ability to coordinate activities with team members.
• Ability to multi-task, adapt to change, manage shifting priorities and meet timelines.
• Possesses excellent interpersonal and communication skills.
• Detailed knowledge of all medical claim coding requirements.
• Strong attention to detail, analytical skills and problem-solving skills.
• Must have solid work ethic and positive demeanor.
• Strong computer knowledge.